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2022-149A
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2022-149A
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Last modified
5/26/2023 10:33:49 AM
Creation date
5/26/2023 10:32:28 AM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
08/16/2022
Control Number
2022-149A
Agenda Item Number
8.Z.
Entity Name
Blue Cross Blue Shield of Florida, Inc.
Subject
BlueMedicare Group Master Agreement Renewal
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inform us that they are no longer eligible to participate in your retiree group health plan. If Florida Blue <br />determines that a Covered Person is ineligible for continued enrollment or if you instruct us to disenroll <br />an individual, you must: <br />1. Provide us with at least thirty (30) calendar days advanced notice of the ineligibility or <br />disenrollment election of an individual; and <br />2. Provide the Covered Person(s) who will be disenrolled with at least twenty one (21) calendar days <br />advanced notice of the termination and of other insurance options that are available to them. You <br />will include language provided by Florida Blue in this notice to meet specific CMS Requirements <br />for notice contents. <br />The Covered Person will have the opportunity to elect another plan offered by us or by you, join Original <br />Medicare, or join another carrier's Medicare Plan (by submitting an enrollment request to that <br />organization). <br />SECTION 4: TERM AND TERNIINATION <br />A. Term of Agreement and Renewal Process <br />This Agreement shall become effective as of the Effective Date provided: (1) that we accept your Group <br />Application; and (2) that you pay the required initial Premium specified by us. <br />This Agreement shall continue in effect until the first Anniversary Date following the Effective Date <br />unless terminated earlier as permitted by its terms. After the initial term, this Agreement shall <br />automatically renew each succeeding year on the Anniversary Date for an additional one-year period <br />unless: <br />1. At least sixty (60) calendar days prior to such Anniversary Date, you notify us that you do not <br />want the Agreement to automatically renew; or <br />2. It is terminated as permitted by its terms. <br />At least ninety (90) calendar days before each Anniversary Date, we will provide you with notice of <br />changes in Premium and benefits under the Medicare Plan for the upcoming year (the "Renewal Notice"), <br />If this Agreement renews as specified above, all of its terms and provisions (including the Premium due) <br />shall be amended to include the terms of the Renewal Notice, and the amended Agreement shall govern <br />coverage as of the Anniversary Date. Payment of the new charges shall constitute acceptance of the change <br />in Premium rates. This Agreement is conditionally renewable. This means that it automatically renews <br />each year on your Anniversary Date unless terminated earlier in accordance with its terms. <br />B. Termination by Group <br />The Group may cancel this Agreement on its Anniversary Date by giving written notice to us at least sixty <br />(60) calendar days in advance, unless we have initiated a termination for any of the reasons stated below. <br />C. Termination by Florida Blue <br />We may terminate this Agreement or refuse to renew for the following reasons: <br />4 <br />
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